• Pediatric Infection and Vaccine
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• v.16 no.2
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• pp.175-182
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• 2009

Purpose : A number of countries have experienced an increase in pertussis during the past decade. In particular, there has been an increase in the incidence rate among adolescents and adults. To learn more about the current epidemiology of pertussis, we studied the prevalence and clinical characteristics of pertussis in children in Cheonan, South Korea. Methods : We collected nasopharyngeal aspirates of 118 patients who were treated for respiratory symptoms at Dankook Univeristy Hospital between March 2008 and September 2009. We performed multiplex PCR for detection of Bordetella pertussis in those aspirates. Results : Of the 118 patients, 10 (8%) were positive by PCR for B. pertussis. Six episodes occurred during the period July to September 2009. Nine of the 10 patients were less than 3 months old. Seven of them had not received DTaP vaccine. The mean duration of coughing before diagnosis was 10.9${\pm}$5.2 days. Ten patients (100%) had paroxysmal cough and 8 (80%) had post-tussive vomiting. Only one patient had fever. One who had complications that include pneumonia, atelectasis and pneumomediastinum developed an absolute increase in leukocyte count (84,400/$mm^3$). There was a statistically significant relation between vaccine being received and development of complications (P =0.033). Conclusion : We suspect that there was an epidemic of pertussis between July and September 2009. Further investigation by a pediatric or nationwide surveillance system is needed to monitor the changing epidemiology for pertussis.

• Pediatric Infection and Vaccine
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• v.24 no.3
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• pp.168-177
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• 2017

Purpose: The purpose of this study was to analyze the clinical features and risk factors of invasive infections caused by Lactobacillus spp. and Saccharomyces spp., components of commercially available probiotics. Methods: We analyzed demographic and clinical data from children ${\leq}18$ years of age with an invasive infection caused by Lactobacillus spp. or Saccharomyces spp. at the Asan Medical Center Children's Hospital from January 1998 to June 2016. Probiotic consumption data were also analyzed. Results: During the study period, a total of 24 episodes of invasive infections were caused by Lactobacillus spp. (n=16) and Saccharomyces cerevisiae (n=8). Along with the increase of probiotic use (755,594 [days/1,000 patient-admission days] in 2001 to 2005, 1,444,066 in 2006 to 2010, and 6,904,736 in 2011 to 2016), the incidence of probiotic-associated invasive infection increased ($R^2=0.70$). The median age of the patients was 1.8 years (range, 2 months to 17 years), and most of them had underlying medical conditions. The 30-day mortality rate was 20.8% (5/24), and 11 (45.8%) of these patients resulted from a severe invasive infection. We determined the risk factors for invasive infection to be: previous intensive care unit stay (odds ratio [OR], 3.0; 95% confidence interval [CI], 1.5 to 6.1] and the presence of a central venous catheter (OR, 2.2; 95% CI, 1.2 to 4.3). Conclusions: Although the probiotic-associated invasive infections rarely occurred in children, the incidence has increased along with probiotic pressure. Judicious use of probiotics is mandatory, especially in young children with underlying medical conditions and continuous surveillance will be needed to minimize the safety concerns.

• Pediatric Infection and Vaccine
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• v.24 no.3
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• pp.125-133
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• 2017

Purpose: After the introduction of Haemophilus influenzae type b (Hib) vaccine in 1995 in Korea, it was included in the national immunization program in 2013. In the post-Hib vaccine era, some studies in other countries reported that invasive Hib disease affects adults, especially the elderly and immunocompromised persons, more often than it affects children. To evaluate disease susceptibility, quantitative and qualitative analysis of anti-polyribosylribitol phosphate (PRP) antibodies were carried out in Korean adults aged 20 to 85 years. Methods: Sera were collected from 39 healthy adults (20 to 50 years of age) and from 30 elderly adults (75 to 85 years of age) who did not have immune-compromising conditions. The concentration of anti-PRP immunoglobulin G (IgG) and serum bactericidal indices (SBIs) were measured by enzyme-linked immunosorbent assay and serum bactericidal assay. Results: Geometric mean concentrations of anti-PRP IgG and geometric mean SBIs were $0.88{\mu}g/mL$ (95% confidence interval [CI], 0.17 to 3.85) and 354 (95% CI, 50 to 2,499) in young adults and $1.67{\mu}g/mL$ (95% CI, 0.53 to 5.24) and 449 (95% CI, 146 to 1,376) in elderly adults, respectively. When the threshold of seropositivity for anti-PRP IgG was applied as 0.15 or $1.0{\mu}g/mL$, which is the protective antibody level in children, seropositive rates were 87.2% or 53.8% in young adults and 100% or 60% in elderly adults. The seropositivity rates of the SBI ($SBI{\geq}4$) were 82.1% and 100% in the groups, respectively. Conclusions: Most subjects in the adult and elderly adult groups display immunity to Hib based on quantitative and qualitative antibody levels, but not all. Because high immunization and low Hib circulation rates may reduce the natural Hib immunity in the population, monitoring Hib immunity as well as disease are needed continuously.

• Pediatric Infection and Vaccine
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• v.24 no.3
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• pp.134-140
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• 2017

Purpose: Severe combined immunodeficiency (SCID) is the most serious form of primary immunodeficiency. Infants with SCID are susceptible to life-threatening infections. To establish newborn screening for SCID in Korea, we performed a screening test for T-cell receptor excision circle (TREC) and ${\kappa}$-deleting recombination excision circle (KREC) in neonates and investigated the awareness of SCID among their parents. Methods: Collections of dried blood spots from neonates and parent surveys were performed at the Samsung Medical Center and Cheil General Hospital & Women's Healthcare Center in Korea. The amplification crossing point (Cp) value <37.0 was defined as TREC/KRECpositive based on cutoff values from measuring multiplex real-time polymerase chain reaction. A Cp value >39.0 was defined as negative. Results: For TREC/KREC screening, 141 neonates were enrolled; 63 (44.7%) were male. One hundred forty neonates (99.3%) had positive TREC/KREC results at the time of the initial test; 82.3% and 75.9% were positive and 17.0% and 23.4% were weakly positive for TREC and KREC, respectively. In one neonate (0.7%), the initial TREC/KREC test result was negative. However, repeated tests obtained and confirmed a positive result. For an awareness survey, 168 parents were engaged. Only 2% of parents (3/168) knew that the newborn screening test for SCID had been introduced and performed in other countries. Eighty-four percent of parents (141/168) replied that nationwide newborn SCID screening should be performed in Korean newborns. Conclusions: In this study, newborn SCID screening was performed along with assessment of public awareness of the SCID test in Korea. The study results showed that newborn SCID screening can be readily applied for clinical use at a relatively low cost in Korea.

• Pediatric Infection and Vaccine
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• v.24 no.3
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• pp.160-167
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• 2017

Purpose: Because children with asplenia have an increased risk of fulminant infection associated with a high fatality, chemoprophylaxis, and vaccinations against encapsulated bacteria are recommended. However, there have been few reports of the burden of severe bacterial infection and the current status of chemoprophylaxis and immunization among children with asplenia in Korea. Methods: We conducted a retrospective study including children with asplenia who were treated at our institute between January 1997 and December 2016. Results: From a total of 213 children with asplenia, 114 (53.5%) had congenital asplenia and 58 (27.2%) had functional asplenia. The remaining 41 (19.3%) had acquired asplenia with the median age at splenectomy being 12.2 years (range, 5.0 to 16.9 years); the most common cause of splenectomy was hereditary spherocytosis (39.0%). The chemoprophylaxis rate was 16.4%. The immunization rates were 44.1% for pneumococcus, 53.0% for Haemophilus influenzae type B, and 10.7% for meningococcus. The incidence of invasive bacterial infection among children with asplenia was 0.28/100 person-year; a total of six episodes (2.8%) were observed in five patients with congenital asplenia and one patient with functional asplenia. The median age for these infections was 15 months (range, 4 to 68 months). Five of the six episodes were bacteremia, and the other was meningitis. The most common pathogen was Streptococcus pneumoniae (n=3), followed by H. influenzae (n=1). Three of the six patients (50.0%) died, all of whom had pneumococcal bacteremia. None of the six had chemoprophylaxis or proper vaccinations. Conclusions: Although there is an increased risk of a severe infection proper vaccinations and chemoprophylaxis are still lacking. Physicians should be encouraged to implement appropriate chemoprophylaxis and immunizations for patients with asplenia.

• Journal of Preventive Medicine and Public Health
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• v.17 no.1
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• pp.47-55
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• 1984

To study the risk factors associated with maternal HBsAg carrier and the effects of maternal HBs antigenemia on the neonatal health, sera of 729 pergnant women admitted to the Keimyung University Hospital for delivery during the period of February 1-May 30. 1982 were tested for HBsAg by RPHA method and for anti-HBs by PHA method. Among them 43 women (5.9%) had HBsAg and 246 women (33.7%) had anti-HBs giving an infection rate of 39.6%. The interview data for 43 HBsAg positive mothers and randomly selected 210 HBsAg negative mothers showed a statistically significant association between acupuncture history and HBsAg positive rate (p<0.005) which suggest that acupuncture might have contributed significantly to the propagation of viral hepatitis in Korea. The living standard of HBsAg positive mothers was generally lower than that of HBsAg negative mothers which supports the hypothesis that environmental factors are associated with viral hepatitis B infection. None of the 43 neonates born to HBsAg positive mothers had HBsAg in their cord blood. Three months after birth, 35 out of 43 infants were retested and only one infant became HBsAg positive. At six months of age, 32 out of 35 infants were retested and none of them were HBsAg positive except the same infant who was positive at three months. Among 20 control infants of HBsAg negative mothers, all of them were HBsAg negative at three and six months follow-up. These findings are not consistent with the supposition that perinatal infection is a main route of viral hepatitis B transmission in south-east Asia including Korea. HBsAg positive mothers had significantly higher rate of premature delivery (27.9%) than HBsAg negative mothers (11.7%) (p<0.05). Also, the low birthweight incidence rate was higher among HBsAg positive mothers (23.3%) than negative mothers (14.1%) but this was not statistically significant (P=0.16). The premature rupture of membrane was more frequent among HBsAg positive mothers (25.5%) than negative mothers (11.1%) (p<0.05). There were no significant differences in the stillbirth rate and incidence of congenital anomalies between HBsAg positive and negative groups. It was not clarified in this study due to small sample size whether higher incidence of premature delivery and premature rupture of membranes among HBsAg positive mothers was due to HBs antigenemia per so or their lower living standard than HBsAg negative mothers.

• Journal of Preventive Medicine and Public Health
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• v.17 no.1
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• pp.145-172
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• 1984

In order to assess the physical growth pattern of Korean Youth, the authors measured the body height, body weight, chestgirth and sitting height of 40967 persons (24832 males and 16135 females) from primary schools, middle and high schools and colleges of metropolitan (urban) and rural areas, and calculated the mene, standard deviation, standard error and coefficient variance of the body weight chestgirth, sitting height and various pertinent index by body height to demonstrate the standard physical growth and development by body height of sex and age. The following conclusions were obtained. 1. Physical growth and development: Rapid growth of physical growth in terms of body height has been observed among males in the age $7{\sim}15$ and among female $7{\sim}13$. Growth in terms of body height turned out to be slower among students of higher age by both sexes. The age of cross over between to sexes is between 10 to 13 years where upon girls out grows boys. Maximum annual growth were upon girls out grows boys. Maximum annual growth were both of 6.16cm from 8 to 9 years old and 12 to 13 years old for boys and 7.2cm from 8 to 9 and 6.1cm from 9 to 10 for girls. This indicates that girls enter a rapidly growing stage 2 years earlier than boys. Meanwhile, prominent improvement in body height of national students over period of ten year was noticed. 2. The distribution status of body height by age: The distribution status of body height by age were as follows; 7 year of age: boys-30cm range of body height from 104.0cm to 133.9cm, girls-27cm from 104.0cm to 130.9cm 8 year of age: boys-30cm from 116.0 to 145.9cm girls-33cm from 113.0 to 145.9cm 9 year of age: boys-30cm from 116.0 to 145.9cm girls-33cm from 113.0 to 145.9cm 10 year of age: boys-39cm from 116.0 to 154.9cm girls-39cm from 119.0 to 157.9cm 11 year of age: boys-45cm from 119.0 to 163.9cm girls-39cm from 122.0 to 160.9cm 12 year of age: boys-45cm from 125.0 to 169.9cm girls-42cm from 125.0 to 166.9cm 13 year of age: boys-45cm from 128.0 to 172.9cm girls-42cm from 128.0 to 169.9cm 14 year of age: boys-48cm from 131.0 to 178.9cm girls-36cm from 134.0 to 169.9cm 15 year of age: boys-42cm from 137.0 to 181.9cm girls-33cm from 137.0 to 169.9cm 16 year of age: boys-39cm from 146.0 to 184.9cm girls-30cm from 143.0 to 172.9cm 17 year of age: boys-39cm from 146.0 to 184.9cm girls-27cm from 143.0 to 169.9cm 18 year of age: boys-36cm from 152.0 to 187.9cm girls-27cm from 146.0 to 172.9cm 19 year of age: boys-30cm from 155.0 to 184.9cm girls-24cm from 146.0 to 169.9cm 20 year of age: boys-24cm from 158.0 to 181.9cm girls-l8cm from 149.0 to 166.9cm 3. Standard values of body weight, chest-girth and sitting height by body height of age were found all age groups from 7 to 20 years old and listed in tables from3-a to 16-a. 4. Standard values of relative body weight, relative chestgirth and relative sitting height by body height of age were found all age groups from 7 to 20 years old and listed in tables from 3-b to 16-b. 5. Standard values of physical and nutritional indices (Rohrer index, Kaup index, Vervaeck index and Pelidisi index) by body height of age were found all age groups from 7 to 20 years old and listed in tables from 3-c to 16-c.

• Journal of Preventive Medicine and Public Health
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• v.22 no.1 s.25
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• pp.125-135
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• 1989

This paper was carried out to study on correlation between mentally retardation and lead and zinc. The subjects were 297 mentally retarded children: 132 of Bomyung special school and Sunmyung, which were located in Taegu city of Korea. The former had their parents but the latter had not. The control group 63 children were randomly seleted from the Dong-in primary school near to Medical School of Kyungpook National University. Atomic absorption spectrophotometer, model IL-551 connected with CTF atomizer(IL. 655) was used for the analysis of lead and zinc. The mean value of lead in hair of mentally retarded children was $14.97{\pm}3.71ppm$ which is significantly higher than that of control group, $11.36{\pm}2.83ppm$. But the content of zinc was not significant in both groups. In the lead there was no significant correlation to age but significant negative correlation to IQ. Zinc showed significant correlation to age but not to IQ. Among the handicapped children, no signigicant correlation between orphan group and non orphan group. Handicaps of mentally-retarded children were speech impairment, emotional disturbance, double and triple handicaps, sensory impairment and abnormal dietary patterns. There were significantly higher contents of lead compared with normal group, except the latter two groups. The disease conditions of mentally retarded children were mongolism, autism, cerebral palsy, epilepsy and microcephaly. In comparing with mongolism, significant difference were existent only on the cerebral palsy and group of unknown etiology. We attempted to divide their past history into external etiology and internal etiology, but could not find significant difference. In view of the whole results, the relationship between mentally-retarded children and lead was presumed to be the early time exposure rather than long interval exposure during growth and the contact opportunity was considered important subject in maternal and child health care.

• Journal of Preventive Medicine and Public Health
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• v.38 no.1
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• pp.25-37
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• 2005

Objective : To estimate the magnitude of psychosocial distress and examine eligible factors associated with the development of psychosocial distress in Korean employees, using a nationwide sample. Methods : A total of 6,977 workers were recruited from 245 companies. A structured questionnaire was used to assess sociodemographics, health-related behaviors, job characteristics, social support at work, personality traits (locus of control, type A behavior pattern), self-esteem, and psychosocial distress. Results : The results showed that 23 % of workers were categorized as high stress, 73% as moderate, and 5% as normal. Hierarchical multiple regression analysis showed that psychosocial distress was more common in younger workers, both male and female. Regular exercise was negatively associated with increase of psychosocial distress. In job characteristics, as expected, low decision latitude, high job insecurity, and low social support at work were related to high psychosocial distress. Personality traits such as locus of control and type A behavior pattern, and self-esteem were more powerful predictors of psychosocial distress than general characteristics, health-related behavior, and job characteristics. There were some gender differences. While men who are less educated and single (unmarried, divorced, and separated) experienced higher levels of psychosocial distress than those who are educated and married, women who feel high job demand experienced higher levels of psychosocial distress than those who feel low job demand. Conclusions : The proportion of the high stress group was higher than expected, and psychosocial factors like social support and personality characteristics (e. g. locus of control, type A behavior pattern and self-esteem) were more significant factors for psychosocial distress than other variables. This finding suggests that some psychosocial factors, especially inadequate social support, low self-esteem and lack of internal locus of control for the development of psychosocial distress, will also operate as an intervention strategy in the worksite stress reduction program. It is strongly required that worksite stress reduction programs should be established in at both occupational and level as well as in individual levels.

• Journal of Preventive Medicine and Public Health
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• v.27 no.2 s.46
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• pp.200-216
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• 1994

In present study, the authors investigated the possible effect of coffee consumption on serum cholesterol level in 1017 men between the ages of 40 and 59 years, who were randomly selected from the members of Seoul Cohort Study. Serum total cholesterol data was collected with other serologic indices (e.g. systolic blood pressure, diastolic blood pressure, hight, weight, etc.) through the program of biennial health check-up offered by Korean Medical Insurance Corporation (KMIC). The amount of coffee consumption was assessed by a self-administered questionnaire through mailing. Other confounding factors, such as age, body mass index, cigarette smoking, alcohol consumption, physical activity, and other dietary intake pattern were also determined by the questionnaire. The differences in means of serum total cholesterol in compared to non consumers were $-0.4{\pm}3.56mg/dl$ for those drinking less than 1 cup a day, $-0.6{\pm}3.60mg/dl$ for those drinking 1 cup a day, and $7.1{\pm}3.41mg/dl$ for those drinking more than 2 cups a day. Since smoking interacted the relationship between coffee consumption and serum total choleaterol, we re-analyzed those relationship in smokers and non-smokers separately Other atherogenic behaviors were well correlated with total cholesterol, so we adjusted the mean values of serum total cholesterol through multivariate model selection with age(r=0.12), total cigarette index (cigarette-years; r=0.10), Quetelet's index ($Kg/m^2$, r=0.16), daily calory expenditure (kcal/day, r=0.06), weekly meat and poultry consumption(g/week, r=0.05), weekly fish consumption (g/week, r=0.08), other caffeinated beverage intake (cups/week), and the amount of sugar and prim added to the coffee. Among those variables only age, Quetelet's index, fish consumption, and total cigarette index (in smokers) were remained in the models. After adjustment, the corresponing differences of total cholesterol in smokers were changed to $0.4{\pm}5.24mg/dl,\;-0.5{\pm}4.97mg/dl,\;and\;8.9{\pm}4.78mg/dl$, which were significantly different among themselves (P=0.011). In non-smokers, however, the differences were not statistically significant (P=0.76). Adjusted mean values of systolic blood pressure and diastolic blood pressure were also determined to evaluate the direct effect of coffee to cardiovascular system, but their means were not significantly different by coffee consumption(p=0.18 for SBP, p=0.48 for DBP). Asuming instant coffee in the most popular type of coffee in Korea, the association observed in our study between coffee and serum total cholesterol, especially in smokers, is very interesting finding for the connection between coffee and serum total cholesterol, because only 'boiled coffee' tend to show significant lipid raising effect rather than to other types of coffee, like filtered or espresso, in most of the western countries. We concluded that people who drink coffee more than 2 cups a day have significantly higher serum total cholesterol level than those who never drink coffee, especially in smokers.